Provider Demographics
NPI:1467498436
Name:ASSOCIATES IN WOMEN'S CARE, P.C.
Entity Type:Organization
Organization Name:ASSOCIATES IN WOMEN'S CARE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRENT
Authorized Official - Middle Name:DELEATH
Authorized Official - Last Name:SHELTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:719-591-6666
Mailing Address - Street 1:6011 E. WOODMEN RD.,
Mailing Address - Street 2:SUITE 320
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80923
Mailing Address - Country:US
Mailing Address - Phone:719-591-6666
Mailing Address - Fax:719-573-0731
Practice Address - Street 1:6011 E. WOODMEN RD.,
Practice Address - Street 2:SUITE 320
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80923
Practice Address - Country:US
Practice Address - Phone:719-591-6666
Practice Address - Fax:719-573-0731
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-20
Last Update Date:2009-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04014221Medicaid
CO04014221Medicaid